Development of cognitive performance in children before and after surgical treatment of pharmacoresistant temporal lobe epilepsy

Česká verzia

Authors: K. Bukačová- ^{1 3}; A. Maulisová ^2,3; A. Jahodová ²; M. Kudr ²; G. A. Ramos Rivera ⁴; P. Kršek ²
Published in the journal: Cesk Slov Neurol N 2024; 87(4): 275-281
Category: Krátké sdělení
doi: https://doi.org/10.48095/cccsnn2024275

Summary

This case study focuses on the long-term cognitive sequelae of temporal lobe epilepsy (TLE) in childhood and their influence by surgical treatment. The study follows four pediatric patients with TLE who underwent successful resectional epilepsy surgery at the Motol Epilepsy Center. While the standard measure of success of epilepsy surgery is postoperative seizure cessation, reduced medication, and improved quality of life, our study also underscores the importance of monitoring the overall neuropsychological profile and providing additional clinical-psychological care. Monitoring of intelligence performance alone is insufficient to fully understand cognitive development after epilepsy surgery. In the cases reported, we documented a gradual consolidation of cognitive functions over time. Comprehensive care, interdisciplinary collaboration, and early indication for epilepsy surgery are crucial to achieve an overall favorable outcome. Early referral of pharmacoresistant patients to specialized centers and prompt effective treatment of epileptic seizures are essential to prevent long-term negative consequences of untreated epilepsy, including cognitive difficulties and psychosocial problems. Simultaneously, further research into the neuropsychology of TLE in children and the development of more effective treatment and support strategies for these patients and their families are essential.

Keywords:

epilepsy surgery – Intelligence – temporal lobe epilepsy – longitudinal perspective – cognition in children – cognitive development

Zdroje

1. Manford M, Hart YM, Sander JWAS et al. National General Practice Study of Epilepsy (NGPSE): partial seizure patterns in a general population. Neurology 1992; 42 (10): 1911–1911. doi: 10.1212/wnl.42.10.1911.

2. Helmstaedter C. Cognitive outcomes of different surgical approaches in temporal lobe epilepsy. Epileptic Disord 2013; 15 (3): 221–239. doi: 10.1684/epd.2013.0587.

3. Joplin S, Gascoigne M, Barton B et al. Accelerated long-term forgetting in children with temporal lobe epilepsy: a timescale investigation of material specificity and executive skills. Epilepsy Behav 2022; 129: 108623. doi: 10.1016/j.yebeh.2022.108623.

4. Orduña BE, Del Castillo MDLCF, Cámara Barrio S et al. Cognitive and behavioral profiles of pediatric surgical candidates with frontal and temporal lobe epilepsy. Epilepsy Behav 2021; 117: 107808. doi: 10.1016/j.yebeh. 2021.107808.

5. Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med 2000; 342 (5): 314–319. doi: 10.1056/NEJM200002033420503.

6. Höller Y, Kutil R, Klaffenböck L, Thomschewski A et al. High-frequency oscillations in epilepsy and surgical outcome. A meta-analysis. Front Hum Neurosci 2015; 9: 574. doi: 10.3389/fnhum.2015.00574.

7. Lamberink HJ, Otte WM, Blümcke I et al. Seizure outcome and use of antiepileptic drugs after epilepsy surgery according to histopathological diagnosis: a retrospective multicentre cohort study. Lancet Neurol 2020; 19 (9): 748–757. doi: 10.1016/S1474-4422 (20) 30220-9.

8. Moreira H, Carona C, Silva N et al. Psychological and quality of life outcomes in pediatric populations: a parent-child perspective. J Pediatr 2013; 163 (5): 1471–1478. doi: 10.1016/j.jpeds.2013.06.028.

9. Dwivedi R, Ramanujam B, Chandra PS et al. Surgery for drug-resistant epilepsy in children. N Engl J Med 2017; 377: 1639–1647.

10. Reilly C, Taft C, Edelvik A et al. Health-related quality of life and emotional wellbeing improve in parents after their children have undergone epilepsy surgery – a prospective population-based study. Epilepsy Behav 2017; 75: 196–202. doi: 10.1016/j.yebeh.2017.07.042.

11. Conway L, Widjaja E, Smith ML. Impact of resective epilepsy surgery on health-related quality of life in children with and without low intellectual ability. Epilepsy Behav 2018; 83: 131–136. doi: 10.1016/j.yebeh.2018.03.036.

12. Lendt M. Behavioural disorders in children with epilepsy: early improvement after surgery. J Neurol Neurosurg Psychiatry 2000; 69 (6): 739–744. doi: 10.1136/jnnp.69.6.739.

13. Puka K, Tavares TP, Smith ML. Development of intelligence 4 to 11 years after paediatric epilepsy surgery. J Neuropsychol 2017; 11 (2): 161–73. doi: 10.1111/jnp.12081.

14. Reilly C, Hallböök T, Viggedal G et al. Parent-reported symptoms of ADHD in young people with epilepsy before and two years after epilepsy surgery. Epilepsy Behav 2019; 94: 29–34. doi: 10.1016/j.yebeh.2019.02.003.

15. Phillips NL, Widjaja E, Speechley K et al. Longitudinal changes in emotional functioning following pediatric resective epilepsy surgery: 2-year follow-up. Epilepsy Behav 2021; 114 (Pt A): 107585. doi: 10.1016/j.yebeh. 2020.107585.

16. Cross JH, Reilly C, Gutierrez Delicado E et al. Epilepsy surgery for children and adolescents: evidence-based but underused. Lancet Child Adolesc Health 2022; 6 (7): 484–494.

17. Loddenkemper T, Holland KD, Stanford LD et al. Developmental outcome after epilepsy surgery in infancy. Pediatrics 2007; 119 (5): 930–935. doi: 10.1542/peds.2006-2530.

18. Cornaggia CM, Beghi M, Provenzi M et al. Correlation between cognition and behavior in epilepsy. Epilepsia 2006; 47 (Suppl 2): 34–39. doi: 10.1111/j.1528-1167.2006.00685.x.

19. Ott D, Siddarth P, Gurbani S et al. Behavioral disorders in pediatric epilepsy: unmet psychiatric need. Epilepsia 2003; 44 (4): 591–597. doi: 10.1046/j.1528-1157.2003.25002.x.

20. Nickels KC, Zaccariello MJ, Hamiwka LD et al. Cognitive and neurodevelopmental comorbidities in paediatric epilepsy. Nat Rev Neurol 2016; 12 (8): 465–476. doi: 10.1038/nrneurol.2016.98.

21. Skirrow C, Cross JH, Harrison S et al. Temporal lobe surgery in childhood and neuroanatomical predictors of long-term declarative memory outcome. Brain 2015; 138 (Pt 1): 80–93. doi: 10.1093/brain/awu313.

22. Shurtleff HA, Barry D, Firman T et al. Impact of epilepsy surgery on development of preschool children: identification of a cohort likely to benefit from early intervention. J Neurosurg Periatr 2015; 16 (4): 383–392. doi: 10.3171/2015.3.PEDS14359.

23. Mohan M, Keller S, Nicolson A et al. The long-term outcomes of epilepsy surgery. PLoS ONE 2018; 13 (5): e0196274. doi: 10.1371/journal.pone.0196274.

24. Bjellvi J, Olsson I, Malmgren K et al. Epilepsy duration and seizure outcome in epilepsy surgery: a systematic review and meta-analysis. Neurology 2019; 93 (2): e159–e166. doi: 10.1212/WNL.00000000000 07753.

25. Skirrow C, Cross JH, Cormack F et al. Long-term intellectual outcome after temporal lobe surgery in childhood. Neurology 2011; 76 (15): 1330–1337. doi: 10.1212/WNL.0b013e31821527f0.

26. Boshuisen K, Van Schooneveld MMJ, Uiterwaal CSPM et al. Intelligence quotient improves after antiepileptic drug withdrawal following pediatric epilepsy surgery. Ann Neurol 2015; 78 (1): 104–114. doi: 10.1002/ana.24 427.

27. Kadish NE, Bast T, Reuner G et al. Epilepsy surgery in the first 3 years of life: predictors of seizure freedom and cognitive development. Neurosurgery 2019; 84 (6): E368–E377. doi: 10.1093/neuros/nyy376.

28. Helmstaedter C, Beeres K, Elger CE et al. Cognitive outcome of pediatric epilepsy surgery across ages and different types of surgeries: a monocentric 1-year follow-up study in 306 patients of school age. Seizure 2020; 77: 86–92. doi: 10.1016/j.seizure.2019. 07.021.

29. Van Schooneveld MMJ, Braun KPJ. Cognitive outcome after epilepsy surgery in children. Brain Dev 2013; 35 (8): 721–729. doi: 10.1016/j.braindev.2013.01.011.

30. Schmidlechner T, Zaddach M, Heinen F et al. IQ changes after pediatric epilepsy surgery: a systematic review and meta-analysis. J Neurol 2024; 271 (1): 177–187. doi: 10.1007/s00415-023-12002-8.